Provider Demographics
NPI:1134972003
Name:MUHIA, KELVIN (RN BSN)
Entity type:Individual
Prefix:
First Name:KELVIN
Middle Name:
Last Name:MUHIA
Suffix:
Gender:M
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KRISTINA WAY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4282
Mailing Address - Country:US
Mailing Address - Phone:978-398-4266
Mailing Address - Fax:
Practice Address - Street 1:11 KRISTINA WAY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4282
Practice Address - Country:US
Practice Address - Phone:978-398-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2330522163WC0400X, 163WH0500X
NH093440-21163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health